Essential Palatal Myoclonus

Introduction: Palatal myoclonus is a rare condition presenting with clicking sound in ear or muscle tremor in pharynx. There are two varieties: essential and symptomatic. Various treatment options exists ranging from watchful observation to botulinum toxin injection. We have not found any reported case of palatal myoclonus from our country. Here we present a case of essential palatal myoclonus managed with clonazepam. Case report: A young female presented in Ear Nose and Throat clinic with complain of auditory click and spontaneous rhythmic movement of throat muscles for eight months. On examination, there was involuntary, rhythmic contraction of bilateral soft-palate, uvula, and base of tongue. Neurological, eye, and peripheral examination were normal. A diagnosis of essential palatal myoclonus was made. It was managed successfully with clonazepam; patient was still on low dose clonazepam at the time of making this report. Conclusion: Essential palatal myoclonus can be clinically diagnosed and managed even in settings where MRI is not available or affordable.

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Use of bilateral suture lateralisation technique in severe paradoxical vocal fold movement, allowing removal of long-term tracheostomy: case report

The Journal of Laryngology & Otology ◽

10.1017/s0022215111003318 ◽

2012 ◽

Vol 126 (3) ◽

pp. 328-330 ◽

Cited By ~ 1

Author(s):

J van Griethuysen ◽

C Al Yaghchi ◽

G Sandhu

Keyword(s):

Case Report ◽

Botulinum Toxin ◽

Vocal Fold ◽

Botulinum Toxin Injection ◽

Rare Condition ◽

Behaviour Therapy ◽

Emergency Tracheostomy ◽

Cognitive Behaviour ◽

Paradoxical Vocal Fold Movement

AbstractObjective:We report a novel bilateral suture lateralisation technique that allowed permanent tracheostomy decannulation in a patient with severe paradoxical vocal fold movement.Case report:A 45-year-old woman presented to the accident and emergency department with worsening shortness of breath. Flexible nasoendoscopy revealed limited vocal fold abduction and an emergency tracheostomy was sited; this was subsequently changed to a long-term Silver Negus tube. Her tracheostomy care was complicated by discomfort and dislodgement. The diagnosis of paradoxical vocal fold movement was only made when the patient presented to our department. Cognitive behaviour therapy and botulinum toxin injection were tried without success. A right vocal fold lateralisation procedure was performed, which enabled temporary tracheostomy decannulation. A left vocal fold lateralisation procedure was subsequently performed and the patient was successfully decannulated, with significant improvement in quality of life.Conclusion:Paradoxical vocal fold movement is a rare condition that is most commonly managed by biofeedback sessions, relaxation manoeuvres or botulinum toxin injection. However, in cases similar to ours in which these treatments are unsuccessful, we suggest a ‘last resort’ technique to manage this rare condition.

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Management of middle ear myoclonus

The Journal of Laryngology & Otology ◽

10.1017/s0022215100126866 ◽

1994 ◽

Vol 108 (5) ◽

pp. 380-382 ◽

Cited By ~ 50

Author(s):

Lydis Badia ◽

Abhi Parikh ◽

Gerald B. Brookes

Keyword(s):

Differential Diagnosis ◽

Botulinum Toxin ◽

Middle Ear ◽

Clinical Assessment ◽

Botulinum Toxin Injection ◽

Rare Condition ◽

Palatal Myoclonus ◽

Management Regimes ◽

History Of ◽

Tensor Tympani Tendon

AbstractTinnitus produced by synchronous repetitive contraction of the middle ear muscles (middle ear myoclonus) is a rare condition.We present six cases of middle ear myoclonus in whom different management regimes were successful. In two patients, the tinnitus was controlled by conservative measures. In one patient, whose tinnitus was associated with blepharospasm, significant improvement occurred following botulinum toxin injection into the ipsilateral orbicularis oculi. Three patients were cured by tympanotomy with stapedial and tensor tympani tendon section.The aetiology of this type of myoclonus remains unclear. The diagnosis is based on the history of involuntary and rhythmic clicking or buzzing tinnitus which is invariably unilateral. The primary differential diagnosis is palatal myoclonus whilst other local aural pathologies must be excluded by careful clinical assessment. Surgical section of these muscles via tympanotomy brings guaranteed relief when conservative measures fail.

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Hereditary geniospasm in a mother and son treated with botulinum toxin injection: A case report

SAGE Open Medical Case Reports ◽

10.1177/2050313x21993593 ◽

2021 ◽

Vol 9 ◽

pp. 2050313X2199359

Author(s):

Clare Perkins ◽

Wei Jia ◽

James Rainsbury ◽

Andrew Lux

Keyword(s):

Case Report ◽

Botulinum Toxin ◽

Side Effects ◽

Beta Blockers ◽

Botulinum Toxin Injection ◽

Treatment Options ◽

Benign Disorder ◽

The World ◽

Botulinum Toxin Injections

Hereditary geniospasm is a rare and benign disorder that can cause distress and social embarrassment to patients. There are only a handful of possible treatment options available. Due to the rarity of the condition, practices differ across the world and the results are varied. These include beta-blockers, benzodiazepines and anti-epileptics. These treatments can have significant side-effects when used long term. However, botulinum toxin injections have been successfully used in a handful of cases. We report a successful botulinum treatment of hereditary geniospasm in a mother and son, with the injection protocols.

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Gummy Smile Treatment by Botulinum Toxin Injection: A Case Report

10.26226/morressier.5ac383172afeeb00097a4706 ◽

2018 ◽

Author(s):

Emel Ataman-Duruel

Keyword(s):

Case Report ◽

Botulinum Toxin ◽

Botulinum Toxin Injection ◽

Gummy Smile

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A Systematic Review of the Omohyoid Muscle Syndrome (OMS): Clinical Presentation, Diagnosis, and Treatment Options

Annals of Otology Rhinology & Laryngology ◽

10.1177/0003489421995037 ◽

2021 ◽

pp. 000348942199503

Author(s):

Jerome Zhiyi Ong ◽

Alex Chengyao Tham ◽

Jian Li Tan

Keyword(s):

Systematic Review ◽

Botulinum Toxin ◽

Traumatic Event ◽

Botulinum Toxin Injection ◽

Treatment Options ◽

Neck Mass ◽

Good Prognosis ◽

Common Symptom ◽

Management Options ◽

Omohyoid Muscle

Objective: Omohyoid muscle syndrome (OMS) is a condition that causes a X-shaped lateral neck lump on swallowing, caused by the failure of the central tendon of the omohyoid muscle to restrict movement of the muscle during swallowing. We aim to review the etiology, pathophysiology, diagnostic tests, and management options for this condition. Data Sources: Pubmed, MEDLINE, EMBASE, and Cochrane databases were searched for all articles and abstracts related to OMS up to 29th July 2020. Review Methods: A systematic review was performed, data extracted from relevant full text articles. Both quantitative data and qualitative data were analyzed. Results: Twenty cases of OMS were reported. Patients presented at a mean age of 36.0. All cases were Asian. There is a 7:3 ratio of males to females. The most common symptom was a transient neck mass. Most cases were managed conservatively with good prognosis. Open or endoscopic transection of the muscle and ultrasound-guided botulinum toxin injection were 3 treatment options, with no recurrence at 4 years, 6 months, and 6 months respectively. Conclusion: OMS could be genetic as all cases were Asian in ethnicity. The deep cervical fascia which usually envelopes the omohyoid muscle may be weakened by stress as 20% of cases had a preceding traumatic event. Real-time ultrasonography establishes the diagnosis, demonstrating the anterolateral displacement of the sternocleidomastoid muscle by a thickened omohyoid muscle during swallowing. Surgical transection can achieve cure, but due to limited studies available, they should be reserved for patients who are extremely bothered. Intramuscular injection of botulinum toxin is an effective alternative, but recurrence is expected.

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